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OSINAGA, V. L. M. “Comparative study between health, mental disease and psychiatric care concepts according to patients and family members”. 2004. p.164. Tese de Doutorado – Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto – SP. The social representation of illness is constructed on the basis of experiencies with illness, which are translated into direct expressions of suffering. These expressions need to be organized into a total that makes sense, to which meanings are attributed. During the last three in decades, we have witnessed a movement towards the realization of profund changes in psychiatric care, proposing ethical institutional and community treatments, concomitantly with a movement away from hospitalization. Evaluating care quality from the user’s perspective becomes increasingly necessary. Thus, we can find out about attitudes towards the received care. These data are beneficial to the organization of health services, workers and users. This estudy aimed to compare the opinions of mental disease patients and their family members about health and mental disease concepts and about psychiatric care delivered at three mental health care services. For the realization of this research, a long road was traveled to reformulate and validate the data collection instrument EMO – Opinion Measure Scale, which consists of 34 questions about Concept and Care in mental health and offers elements for analysis and reflections. The study sample was made up by 250 persons who attended the selected three psychiatric care services (Emergency Unit, Psychosocial Care Center and Regional Mental Health Clinic), including 125 patients and 125 who accompanied them at each of these services. During sociodemographic and clinical analysis, we verified the gender factor of the mental disease patients at the 3 services (Emergency Unit, Psychosocial Care Center and Regional Mental Health Clinic), which revealed a higher concentration of women, corresponding to 60%, and 66% respectively. The same tendency is disclosed among the companions, that is, more women assume the role of caretaker, with 63%, 67% and 68%. Clinical profile date confirm the presence of divergences, such as those related to diagnosis. These attract a lot of attention, not only due to the lack of cohesion between the medical diagnosis informed by patients or family members, but also due to the little importance given to this fact, which is so relevant for patients suffering from mental diseases. The patient age profile was younger ar the UE, with low education levels and no profession or qualification During statistical analysis, we observed a difference in dominion (concepts and care) at the three locations. Their comparison revealed a lower average score for PCC patients (2.36) and their companions (2.20). Agreement values for the Concepts dominion are higher than those for Care, at all locations, for Patients as well as for Companions. The fact that there is greater divergence among opinions about Concepts than among those about Care reflects the subjects’ experiences in the middle of na intense conceptual and ideological change process. During reflective analysis, it was noted that, although it is impossible to highlight the kind of divergence subjects present in relation to Concepts, Care and Mental Health, the test demonstrated that they exist. Other element that stand out in the analysis are family issue, as a participant element in the entire therapeutic process, and team issues, as a set of elements inserted in the reform movement, seeking to offer ethical and respectful care. However, it is demonstrated that changes ocurr neither in a linear way nor with equal intensity in all segments, but that they are occurring.

"Estudo comparativo entre os conceitos de saúde e de doença mental e a assistência psiquiátrica, segundo portadores e familiares"